My Sciatica Secret
Let’s talk about sciatica.
I’d like to tell about you a little about how we diagnose and treat it to help our patients get relief from this debilitating nerve pain so you can see if we might be right for you.
What is “Sciatica”?
Sciatica is a specific nerve pain felt in the leg that radiates (travels) from the lower back and down the back of the leg. It can go as far as the foot, but not always.
Spine Health have a page here if you want to read even more about it.
We see a tonne of patients in our office who have sciatica or sciatic-like pain. Usually, by the time patients find us they have tried the popular treatments. Treatments like remedial massage, chiropractic manipulation, exercise therapy, ultrasound, physiotherapy or even changed their diet. Most patients have experienced short term relief but not lasting relief.
What you might not know is that ‘sciatica’ is a symptom and not a diagnosis! Like most symptoms, it can have many potential causes, some serious and some not. Disc bulges, acute muscle spasm and spinal fractures are some you might have heard of. But before we go any details on how we approach this type of nerve pain….
Reminder: The following information is general in nature and should not be a substitute for medical advice from your health practitioner. Always seek the advice and guidance of a professional before acting on any information you find on the internet.
So, what do we do?
As always, we must take a detailed history and examination to identify any potentially serious causes for your sciatica that require immediate medical attention or any causes that require a referral to another health professional.
Once we identify that you are a candidate for treatment, we can begin.
A lesser-known cause of sciatic pain is ‘entrapment’ of the nerve by adhesions at the external rotators of the hip in the deep gluteal space.
What does that mean? Glad you asked. The nerve can be ‘trapped’ behind your hip bone and can be a cause of pain. Some patients, before treatment have described also having had (other than sciatic pain):
Tightness in the lower back when bending forward
Tight hamstrings without back pain or injury to the spine
Poor flexibility in the lower body generally
Local pain with pressure (pushing over the nerve)
Pain with running when their foot strikes the ground when the knee is straightened
Pain behind the knee with even mild or gentle stretching of the hamstrings or hips
Previously diagnosed Piriformis Syndrome
When the sciatic nerve is ‘adhered’ to the deep muscles of the hip it experiences increased stretching forces during normal daily movement. Chronic stretching of the nerve, over time, can cause inflammation and pain. To protect this important nerve your body will contract muscles in the lower back and in the legs (usually the hamstrings) to limit total movement of the hip to stop the stretching of the nerve and prevent damage.
When we treat this nerve, we apply a combination of compression and tension along the nerve, towards the spine and into the fibrous adhesions. Once we have a stable contact on these adhesions we move the leg, bending the hip forward with the knee straight which, slowly, exerts a pulling force on the nerve down the leg and away from the spine. We will do this several times or to tolerance of our patient or the tissues. By doing treatment in this way we are aiming to increase the mobility of the nerve at the hip. When we increase the mobility of the nerve the amount of stretching forces it experiences decreases and often so does pain coming from the sciatic nerve. This is our secret weapon.
However, just like any treatment, it must be applied for the right problem by the right person with the right training.
You should not try this at home.
If this treatment looks like it might be helpful for you in your situation then please reach out and we would be happy to assess you to determine if we can help you. Book here
Linked below is a YouTube video demonstrating a surgical approach to releasing the fibrous adhesions around the sciatic nerve.
